MISS JACQUELINE GONZAGA (NPI# 1447376553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447376553 |
| Entity Type | Individual |
| Full Name | MISS JACQUELINE GONZAGA |
| Practice Address |
1855 N Fair Oaks Ave Pasadena CA 91103-1620 |
| Mailing Address |
14410 S Lime Ave Compton CA 90221-2519 |
| Practice Telephone | 6262967710 |
| Practice Fax Number | 6262967714 |
| Mailing Telephone | 3106354712 |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225400000X | Rehabilitation Practitioner | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MHW | 225400000X | 01 |
| Street Address |
1855 N FAIR OAKS AVE |
| City | PASADENA |
| State | CA |
| Zip Code | 91103-1620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154300630 | Taska K Moore | Obstetrics & Gynecology | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2006-01-12 |
| 1164997144 | Trindiad Flores | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2018-10-05 |
| 1467945287 | Lisa Michelle Cherqaoui | Registered Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2018-06-07 |
| 1124520267 | Ma. Cecilia Alonzo Verceles | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2018-03-05 |
| 1134621329 | Veronica Kay Helmuth | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2018-03-02 |
| 1740781723 | Jacqueline Flores | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2018-02-23 |
| 1144735895 | Angie Byung Ju Kim | Physician Assistant | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2017-12-04 |
| 1790299675 | Graciela Quevedo | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2017-11-30 |
| 1417461526 | Merci Taylor | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2017-11-28 |
| 1164936126 | Marisol Bonner | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2017-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013407071 | Sean Patrick Comingore | Counselor | 1680 N. Fair Oaks Ave., Pasadena, CA 91103 | 2018-05-15 |
| 1093230252 | John Jesus Smith | Rehabilitation Practitioner | 867 Fair Oaks Ave, Pasadena, CA 91103 | 2017-08-09 |
| 1760906085 | Roberto Sotelo Jr. | Licensed Vocational Nurse | 867 North Fair Oaks Ave., Pasadena, CA 91103 | 2017-07-28 |
| 1477076172 | Towana Danielle Hooks | Rehabilitation Practitioner | 867 North Fair Oaks, Pasadena, CA 91103 | 2017-07-25 |
| 1437671807 | Yolanda Centeno | Marriage & Family Therapist | 867 Fairoaks., Pasadena, CA 91103 | 2017-07-07 |
| 1306366604 | Joseph Anthony Zepeda | Counselor | 1680 N. Fair Oaks Avenue, Pasadena, CA 91103 | 2017-06-27 |
| 1922537372 | Chaznii Bradford | Licensed Vocational Nurse | 867 N. Fair Oaks, Pasadena, CA 91103 | 2017-06-08 |
| 1629505425 | Wassim Ammary | Pharmacist | 1855 South Fair Oaks Ave, Pasadena, CA 91103 | 2017-05-11 |
| 1679005920 | Grace Caroline Seto | Marriage & Family Therapist | 236 W. Mountain St, Suite 202d, Pasadena, CA 91103 | 2017-03-28 |
| 1225575293 | Catherine Lynn Gray | Psychologist | 30 North Raymond Avenue, Suite 403, Pasadena, CA 91103 | 2017-01-27 |
| Find all providers in zip 91103 | ||||
| Taxonomy Code | 225400000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Rehabilitation Practitioner |
| A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669008991 | Delman Lee Williams | Rehabilitation Practitioner | 456 E Orange Grove Blvd Ste 140, Pasadena, CA 91104-5235 | 2020-03-18 |
| 1548805344 | Aimee Isabelle Rodriguez | Rehabilitation Practitioner | 100 W Walnut St Ste 375110, Pasadena, CA 91103-3697 | 2019-11-15 |
| 1518427830 | Samantha Jo Elvira Haun | Rehabilitation Practitioner | 867 N Fair Oaks Ave # 867, Pasadena, CA 91103-3050 | 2019-03-22 |
| 1477041580 | Imani Nicole Glenn | Rehabilitation Practitioner | 1575 E Washington Blvd, Pasadena, CA 91104-2675 | 2018-04-24 |
| 1093230252 | John Jesus Smith | Rehabilitation Practitioner | 867 Fair Oaks Ave, Pasadena, CA 91103 | 2017-08-09 |
| 1477076172 | Towana Danielle Hooks | Rehabilitation Practitioner | 867 North Fair Oaks, Pasadena, CA 91103 | 2017-07-25 |
| 1346770443 | Amanda Grace Gentz | Rehabilitation Practitioner | 210 S De Lacey, Ste 110, Pasadena, CA 91105 | 2017-06-13 |
| 1588115281 | Ramon Banuelos | Rehabilitation Practitioner | 210 S. Delacey Ave Suite 110, Pasadena, CA 91105 | 2016-10-18 |
| 1366821613 | Claudia Boileu-flores | Rehabilitation Practitioner | 940 Avenue, 64, Pasadena, CA 91105 | 2015-05-20 |
| 1497161756 | Marine Bambakyan | Rehabilitation Practitioner | 66 Hurlbut St Fl 2, Pasadena, CA 91105-4026 | 2014-07-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.